Drug interactions
Aprepitant + Neratinib
Severity: Major
Aprepitant and Neratinib: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Aprepitant may raise neratinib concentrations via CYP3A4 inhibition. This may worsen neratinib toxicity, notably severe diarrhea and liver injury.
What this interaction means in plain words
Aprepitant and Neratinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Aprepitant belongs to Gastrointestinal Tract; Neratinib belongs to Oncology.
Why it happens
Aprepitant inhibits CYP3A4, the main route of neratinib metabolism.
What to do
Avoid moderate CYP3A4 inhibitors with neratinib and select an alternative antiemetic. If unavoidable, monitor for diarrhea and liver function.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Aprepitant
- Aprepitant + Lomitapide Contraindicated
- Aprepitant + Pimozide Contraindicated
- Aprepitant + Avapritinib Major
- Aprepitant + Bosutinib Major
- Aprepitant + Carbamazepine Major
- Aprepitant + Cobicistat Major
Other interactions of Neratinib
- Amiodarone + Neratinib Major
- Amobarbital + Neratinib Major
- Armodafinil + Neratinib Major
- Bosentan + Neratinib Major
- Carbamazepine + Neratinib Major
- Cimetidine + Neratinib Major
Frequently asked questions
Can I take Aprepitant with Neratinib?
MediHelp rates the interaction as major. Aprepitant and Neratinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Aprepitant may raise neratinib concentrations via CYP3A4 inhibition. This may worsen neratinib toxicity, notably severe diarrhea and liver injury.
How serious is the interaction between Aprepitant and Neratinib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid moderate CYP3A4 inhibitors with neratinib and select an alternative antiemetic. If unavoidable, monitor for diarrhea and liver function.
What other medicines interact with Aprepitant?
MediHelp also lists interactions of Aprepitant with, for example, Lomitapide, Pimozide, Avapritinib. The full list is on the Aprepitant page.
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